Medicare Physician Fee Schedule Geographic Practice Expense Index (GPCI)

Medicare Physician Fee Schedule Geographic Practice Expense Index (GPCI)

OMB: 0938-0575

IC ID: 45685

Documents and Forms
Information Collection (IC) Details

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Medicare Physician Fee Schedule Geographic Practice Expense Index (GPCI)
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-R-143 CMS-R-143 Survey R-143survey.doc No No Paper Only

Health Health Care Services

 

25 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   50 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 25 0 0 25 0 0
Annual IC Time Burden (Hours) 75 0 0 75 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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